Mukati
Ndiina Purofesa Gilles Kayem, chiremba wezvekuzvara-gynecologist paLouis-Mourier hospital (92)
Nangidzira dombo
Kunyangwe cesarean yakarongwa kana nekukurumidza, mukadzi ane pamuviri anoiswa muimba yekuvhiya. Vamwe maternity vanobvuma, kana mamiriro acho ari right, kuti baba varipo padivi pake. Chekutanga, tinochenesa ganda redumbu ine antiseptic chigadzirwa kubva pasi pezvidya kusvika pamwero wechipfuva, nekusimbisa paguvhu. Katheta yeweti inobva yaiswa kuti urambe uchibudisa dundira. Kana amai vachange vatova pachirwere chepidural, murapi anowedzera imwe dosi yezvigadzirwa zveanesthetic kuti apedze kurambwa.
Kuchekwa kweganda
Chiremba wezvekuzvara ava kukwanisa kuita cesarean section. Kare, vertical subumbilical midline incision yaiitwa paganda uye pachibereko. Izvi zvakakonzera kubuda ropa kwakawanda uye vanga rechibereko panguva yaitevera pamuviri rakanga risisina kusimba. Nhasi, ganda uye chibereko zvinowanzochekwa zvakachinjika.. Iyi ndiyo inonzi Pfannenstiel incision. Iyi nzira inovimbisa kusimba kwakawanda. Vanaamai vakawanda vanonetseka pamusoro pokuva nevanga rakakura. Izvi zvinonzwisisika. Asi kana kuchekwa kwakanyanyotetepa, kubvisa mwana kungave kwakaoma. Chinokosha ndechekucheka ganda panzvimbo yakakodzera. Iyo yekare yakakurudzirwa upamhi ndeye 12 kusvika 14 cm. Iyo incision inoitwa 2-3 cm pamusoro pe pubis. Zvakanakira chii? Panzvimbo iyi, vanga racho rinenge risingaonekwe nekuti riri paganda.
Kuvhurwa kwemadziro edumbu
Mushure mekucheka ganda, chiremba wezvekubereka anocheka mafuta uye ipapo fascia (tishu inoputira mhasuru). Unyanzvi hwechikamu checesarean hwakashanduka mumakore achangopfuura pasi pesimba remapurofesa Joël-Cohen naMichael Stark. Mafuta ipapo mamhasuru anopararira kuminwe. Iyo peritoneum inovhurwawo nenzira imwechete inobvumira kupinda mudumbu redumbu uye chibereko. Dumbu remudumbu rine nhengo dzakasiyana siyana sedumbu, colon kana dundira. Iyi nzira inokurumidza. Zvakakosha kuverenga pakati pe1 uye 3 maminitsi kusvika kune peritoneal cavity panguva yekutanga cesarean section. Kupfupisa nguva yekuvhiyiwa kunoderedza kubuda kweropa uye pamwe kunoderedza njodzi yekutapukirwa, izvo zvinogona kuita kuti amai vapore nekukurumidza mushure mekuvhiyiwa.
Kuvhura kwechibereko: hysterrotomy
Chiremba anobva apinda muchibereko. Iyo hysterotomy inoitwa muchikamu chepasi apo tishu iri thinnest. Inzvimbo inobuda ropa zvishoma mukushaikwa kwekuwedzera pathology. Mukuwedzera, ruvara rwechibereko chakasimba kudarika suture yemuviri wechibereko panguva yekuzvitakura kunotevera. Kuberekwa kunouya nenzira yechisikigo nokudaro kunobvira. Kana chibereko chachekwa, gynecologist anowedzera kuchekwa kusvika kuminwe uye kubvarura saga remvura. Pakupedzisira, anobvisa mwana nemusoro kana netsoka zvichienderana nemharidzo. Mwana anoiswa ganda neganda naamai kwemaminitsi mashoma. Cherechedza: kana amai vakatoita cesarean section, kuvhiyiwa kunogona kutora nguva yakati rebei nekuti panogona kuita kusvirana, kunyanya pakati pechibereko nedundira.
dhirivahari
Mushure mekuberekwa, chiremba anobvisa placenta. Uku ndiko kudzikinurwa. Zvadaro, anotarisa kuti uterine cavity haina chinhu here. Chibereko chinobva chavharwa. Chiremba anogona kusarudza kuiburitsa kunze kuti iite suture zviri nyore kana kuisiya mudumbu remudumbu. Kazhinji, visceral peritoneum inovhara chibereko uye dundira haina kuvharwa. Iyo fascia yakavharwa. Ganda redumbu rako iyo, kana iri iyo, yakashongedzwa maererano nevarapi, absorbable suture kana kwete kana nemastaples. Hapana nzira yekuvhara ganda yakaratidza zvirinani aesthetic mhedzisiro mwedzi mitanhatu mushure mekuvhiyiwa
Iyo tekinoroji ye extra-peritoneal cesarean chikamu Muchiitiko che extraperitoneal cesarean chikamu, peritoneum haina kuchekwa. Kuti asvike kuchibereko, chiremba anovhiya anobvisa peritoneum uye anosundira dundira kumashure. Nekudzivisa nzira kuburikidza ne peritoneal cavity, yaizotsamwisa digestive system zvishoma. Kubatsira kukuru kweiyi nzira yecesarean chikamu kune avo vanochipa, ndechekuti amai vaizokurumidza kupora kwekufamba kwematumbo. Zvakadaro, Iyi tekinoroji haina kusimbiswa nechero chidzidzo chekuenzanisa neyemhando yepamusoro. Muitiro wayo nokudaro haunyanyi kuoma. Saizvozvo, sezvo zvakanyanya kuomarara uye zvichitora nguva kuita, hazvigone mune chero mamiriro ezvinhu kuitwa munjodzi. |